Analyst, Data Exchange (Medical, Dental & Vision) New York, New York, United States

New York, New York, United States

Location : Remote

Position Summary :

The Data Exchange Analyst is a crucial member of our Data Operations team, responsible for ensuring the accurate , efficient, and secure exchange of healthcare data between Capital Rx – JUDI Health and its various partners, including employers, providers, and other TPAs. This role focuses on the technical aspects of data integration, file transformation, error resolution, and ongoing monitoring of data feeds for medical, dental, and vision claims. The ideal candidate will possess a strong understanding of healthcare data formats, excellent analytical skills, and a commitment to data integrity and compliance.

Position Responsibilities :

Data Integration & Mapping :

• Design, develop, and maintain data mappings and transformations for incoming and outgoing healthcare data files : 837 / 835 - claims & remittance, 270 / 271 – eligibility and responses, 278 – Prior Auth, 276 / 277 – claim status, 999 / TA1 – file level acknowledgement as well as proprietary formats
• Collaborate with internal teams (e.g., Client Services, Claims, IT Development) and external partners (e.g., clearing houses or third-party administrators) to define data requirements and specifications
• Work with business teams and trading partners to onboard, test and certify new connections and transaction sets

Data Quality & Validation :

Monitoring & Support :

Process Improvement & Automation :

Reporting & Analysis :

Required Qualifications :

This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.

Salary Range

$85,000 - $100,000 USD

About Capital Rx

Capital Rx is a health technology company providing claim administration and technology solutions for carriers, health plans, TPAs, employer groups, and government entities. As a public benefit corporation, Capital Rx is executing its mission to materially reduce healthcare costs as a full-service PBM and through the deployment of Judi, the company's cloud-native enterprise health platform. Judi connects every aspect of the healthcare ecosystem in one efficient, scalable platform, servicing millions of members for Medicare, Medicaid, and commercial plans. Together with its clients, Capital Rx is reimagining the administration of benefits and rebuilding trust in healthcare.

Capital Rx values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

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